Karen Lee Samuels, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0004338 Issued in FL

Practice address

115 E. Granada Boulevard
Suite 7
Ormond Beach, FL 32176-6634

Phone

(386) 255-1646

Fax

(386) 671-3002

NPI assigned

Jan 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598811390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E. GRANADA BOULEVARD",
            "address_2": "SUITE 7",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321766634",
            "telephone_number": "386-255-1646",
            "fax_number": "386-671-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E. GRANADA BOULEVARD",
            "address_2": "SUITE 7",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321766634",
            "telephone_number": "386-255-1646",
            "fax_number": "386-671-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "KAREN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.